Fair Park Counseling Pllc
LBN: Fair Park Counseling Pllc
Fair Park Counseling Pllc is an health care organization with primary practice located at 210 E Main St Ste 2C , Tupelo MS 38804-4017. The organization recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health, Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder. Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder is the primary health care specialty.
Fair Park Counseling Pllc can be contacted via phone (662) 760-0052, or through Ferguson, Kelly W via phone (662) 760-0052.
Contact Information
Primary practice address
210 E Main St Ste 2C
Tupelo MS 38804-4017
Phone: (662) 760-0052
Fax: (662) 495-4080
Website:
Authorized official contact:
Name: Ferguson, Kelly W Licensed Professional Counselor (LPC)
Phone: (662) 760-0052
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | ||
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | ||
| Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder | 261QR0405X |
Profile Details
| NPI number | 1730661331 |
|---|---|
| LBN Legal business name | Fair Park Counseling Pllc |
| DBA Doing business as | |
| Authorized official | Ferguson, Kelly W Licensed Professional Counselor (LPC) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Aug 30th, 2018 |
| Last updated | Nov 7th, 2021 - about 4 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
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